Pneumomediastinum predicts early mortality in acute paraquat poisoning
Pneumomediastinum predicts early mortality in acute paraquat poisoning
复制标题
纵隔气肿可预测急性百草枯中毒的早期死亡
DOI：
10.3109/15563650.2015.1046183
复制
发表时间：
2015-06
影响因子：
3.3
通讯作者：
Peng A.
中科院分区：
文献类型：
--
作者：
Wu T;Mohan C;Hu DY;Peng A.
抽象语境。百草枯（paraquat，PQ）中毒后常出现肺气肿（pneumomegalinum，PM），导致死亡。然而，PQ中毒PM的临床特征和最终结果仍不清楚。Objective.我们的目的是描述PQ中毒后PM的特征及其对预测死亡率的预后价值。材料和方法。入选的PQ中毒患者（n = 75）根据胸部CT能否检出PM分为两组。研究结果包括中毒后5天和90天的死亡。生存曲线采用Kaplan-Meier法绘制，死亡危险因素采用前向逐步考克斯回归分析。结果21.3%的患者（16/75）记录了PM;其中13例患者在摄入PQ后3天内发生PM。15例患者在PM出现后3天内死亡。与非PM患者相比，PM患者的年龄更小（P = 0.011），急性生理学和慢性健康状况评分（P < 0.001）和序贯器官衰竭评分（P = 0.003）更高。此外，PM患者的急性肾功能衰竭（P = 0.001）、中毒性肝炎（P = 0.008）和呼吸功能不全（P = 0.003）的发生率较高。PM预测90天死亡风险增加（93.8%的PM患者vs. 40.7%的无PM患者;风险比[HR]，2.4; 95%置信区间[CI]，1.0-5.6; P = 0.045），5天死亡风险增加（81.3% vs. 27.1%; HR，3.2; 95% CI，1.2-8.1; P = 0.017）。讨论和结论。在8天内发生的早期PM是PQ中毒死亡率的特定预测因子。
Abstract Context. In paraquat (PQ) poisoning, death often occurs after the appearance of pneumomediastinum (PM). However, the clinical features and eventual outcome of PM in PQ intoxication remains unclear. Objective. We aimed to characterize PM following PQ poisoning and its prognostic value for predicting mortality. Materials and methods. Enrolled PQ-poisoned patients (n = 75) were divided into two groups according to whether PM could be detected by chest computed tomography or not. The study outcomes included 5- and 90-day death after intoxication. Survival curves were derived using the Kaplan–Meier method, and mortality risk factors were analyzed by forward stepwise Cox regression analysis. Results. PM was documented in 21.3% of the patients (16/75); in 13 of them PM set in within 3 days of PQ ingestion. 15 patients died within 3 days of appearance of PM. Compared with patients without PM, those with PM were younger (P = 0.011), and had higher scores of Acute Physiology and Chronic Health Evaluation (P < 0.001) and Sequential Organ Failure Assessment (P = 0.003). In addition, patients with PM had a higher incidence of acute renal failure (P = 0.001), toxic hepatitis (P = 0.008), and respiratory insufficiency (P = 0.003). PM predicted an increased risk of 90-day death (93.8% of patients with PM vs. 40.7% among those without PM; hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.0–5.6; P = 0.045), and increased risk of 5-day death (81.3% vs. 27.1%; HR, 3.2; 95% CI, 1.2–8.1; P = 0.017). Discussion and conclusion. Early PM, occurring within 8 days, is a specific predictor of mortality in PQ poisoning.
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DOI：
--
发表时间：
1990-03
期刊：
Kokyu to junkan. Respiration & circulation
影响因子：
--
作者：
J. Kageyama;K. Satoh;Y. Kawase;K. Kojima;T. Tamai;M. Ohkawa;M. Tanabe;Y. Shirakawa;K. Oguri
通讯作者：
J. Kageyama;K. Satoh;Y. Kawase;K. Kojima;T. Tamai;M. Ohkawa;M. Tanabe;Y. Shirakawa;K. Oguri
影响因子：
3.3
作者：
H. Hassanian‐Moghaddam;N. Zamani;S. Shadnia
通讯作者：
H. Hassanian‐Moghaddam;N. Zamani;S. Shadnia
DOI：
10.1016/s0140-6736(79)90345-3
发表时间：
1979-08
期刊：
The Lancet
影响因子：
--
作者：
A. Proudfoot;M. Stewart;T. Levitt;B. Widdop
通讯作者：
A. Proudfoot;M. Stewart;T. Levitt;B. Widdop
DOI：
10.1016/s0140-6736(84)92784-3
发表时间：
1984-11
期刊：
The Lancet
影响因子：
--
作者：
T. B. Hart;A. Nevitt;A. Whitehead
通讯作者：
T. B. Hart;A. Nevitt;A. Whitehead
影响因子：
3.3
作者：
Gil, Hyo-Wook;Kang, Mun-Soo;Hong, Sae-Yong
通讯作者：
Hong, Sae-Yong